Prebiotics in infants for prevention of allergy

Abstract

Further research is needed before routine use of prebiotics can be recommended for prevention of allergy in formula fed infants. There is some evidence that a prebiotic supplement added to infant feeds may prevent eczema. It is unclear whether the use of prebiotic should be restricted to infants at high risk of allergy or may have an effect in low risk populations; or whether it may have an effect on other allergic diseases including asthma.

Prebiotics in infant formula

“…63 A Cochrane meta-analysis of 4 studies found a significant reduction in eczema (1218 infants, typical risk ratio 0.68, 95% CI 0.48 to 0.97; typical risk difference -0.04, 95% CI ¡0.07 to ¡0.00; number needed to treat to benefit 25, 95% CI 14 to >100; P D 0.03). 63 Individual studies reported a significant reduction in asthma and eczema with a mixture of GOS/ FOS (9:1 ratio) (8 g/L) in infants at high allergy risk; and in eczema alone for supplementation with GOS/FOS (9:1) (6.8 g/ L) and acidic OS (1.2 g/L) in infants not randomized by allergy risk. 63,64 On the contrary, a recent study on GOS supplementation during one year reported no difference in allergy.…”

“…63 Individual studies reported a significant reduction in asthma and eczema with a mixture of GOS/ FOS (9:1 ratio) (8 g/L) in infants at high allergy risk; and in eczema alone for supplementation with GOS/FOS (9:1) (6.8 g/ L) and acidic OS (1.2 g/L) in infants not randomized by allergy risk. 63,64 On the contrary, a recent study on GOS supplementation during one year reported no difference in allergy. 19 In this particular field, several studies have been performed with synbiotics.…”

Biome engineering‐2020

“…For a mixture of FOS/GOS, researchers could document not only a 10‐fold faecal bifidobacterial titre increase over placebo recipients (maltodextrin) but also beneficial clinical effects. From meta‐analysis, there is some evidence that a prebiotic supplement added to infant feeds may prevent eczema (Osborn and Sinn, 2013). FOS and GOS also led in adults to an increase in faecal Bifidobacterium with slightly beneficial laxative effects (Kleessen et al ., 1997) and on cholesterol excretion.…”

The gut microbiota and inflammatory noncommunicable diseases: Associations and potentials for gut microbiota therapies

“…Concordantly, infants in rural Africa, where mothers and infants have a traditional diet very high in fermentable carbohydrates, have substantially higher levels of Bacteroidetes and SCFAs in stool compared with infants from Europe, where mothers and infants have a Western diet 44 . In relation to early onset NCDs, there is preliminary evidence that feeding prebiotics (Table II), from early infancy may prevent eczema but these findings are yet to be confirmed 8,30,91 . In the most recent Cochrane review 91 , including 1428 infants at high risk of allergic disease, prebiotics added to infant feeds reduced the risk of eczema (risk ratio 0.68, 95% CI 0.48 to 0.97), with no effect on any other allergic outcomes.…”

“…In relation to early onset NCDs, there is preliminary evidence that feeding prebiotics (Table II), from early infancy may prevent eczema but these findings are yet to be confirmed 8,30,91 . In the most recent Cochrane review 91 , including 1428 infants at high risk of allergic disease, prebiotics added to infant feeds reduced the risk of eczema (risk ratio 0.68, 95% CI 0.48 to 0.97), with no effect on any other allergic outcomes.…”